Review of the hospital-based public health epidemiologist program in North Carolina

The North Carolina Division of Public Health established the hospital-based public health epidemiologist (PHE) program in 2003 to strengthen coordination and communication between hospitals and health departments. Eleven PHEs are based in the state's largest hospitals, covering approximately 39% of general/acute care beds and 30% of emergency department visits. Core activities include surveillance, investigation, outreach and education, special studies, and collaboration with local health departments. To learn about the advantages and disadvantages of this novel program, a survey of current and former PHE staff, participating hospitals, and health departments was conducted from October to November 2007. Phone interviews were completed with 10 of 12 PHEs and 9 health departments; 10 hospitals returned paper surveys for a total of 29 respondents. Overall, the PHE program has been well accepted by both public health and hospital communities. The greatest benefit noted was the improved communication provided by PHEs (n=27). Among 19 public health and PHE respondents, 63% noted improvements in communicable disease reporting. Of 9 health department employees, 78% noted improved work efficiency. Nine of 10 hospitals (90%) noted improvements in enhanced surveillance and bioterrorism/emerging infections preparedness. Few disadvantages of the program were reported but included limited financial support (n=2) and competing priorities (n=2). The hospital-based PHE program has been an innovative means to improve North Carolina's ability to prepare and respond to public health threats through improved communication and collaboration between health departments and local hospitals. These benefits also serve a greater goal of improving public health infrastructure of North Carolina.